What condition is most likely in a 28-year-old woman at 32 weeks of gestation presenting with bright red vaginal bleeding?

In a 28-year-old woman who is 32 weeks pregnant, the presentation of bright red vaginal bleeding is most indicative of placenta previa. This condition occurs when the placenta is improperly positioned low in the uterus, either covering or being very close to the cervical opening. As the cervix begins to change as the pregnancy progresses, this can lead to bleeding, particularly in the third trimester, which aligns with the timing in this case.

Placenta previa can lead to significant complications, including risk of preterm labor and hemorrhage, which is why bright red bleeding can be a critical sign requiring immediate medical attention. Given the timing of the bleeding and the gestational age, it is essential to consider this condition in the differential diagnosis.

While placental abruption does involve bleeding, it typically presents with abdominal pain and can lead to a more acute and severe clinical picture. Acute cervicitis can cause bleeding as well, but it often does not present with bright red bleeding in late pregnancy and is usually accompanied by other symptoms such as unusual discharge or discomfort. Molar pregnancy, while it can cause bleeding, is typically diagnosed earlier in pregnancy and presents differently than in this scenario. Thus, placenta previa best explains the bright red vaginal bleeding in a woman at this